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患者,女,52岁。因乏力1周住院,期间发现胸骨压病,肝脾明显肿大。血红蛋白115g/L,白细胞275×10~9/L,,中晚粒细胞占56％,血小板350×10~9/L。骨髓增生极度活跃,粒系92％,原早粒6％,嗜酸、嗜碱粒细胞及巨核细胞多见,诊断慢性粒细胞白血病。ph′染色体阳性。确诊后经马利兰治疗,症状好转,出院时肝脾不能扪及。1年后因发热半月,伴乏力,全身骨痛再次住院。体查;体温39℃,明显贫血貌,皮肤有散在出血点,胸骨压痛明显,肝肋下2cm,脾平脐。血红蛋白65g/L,白细胞20.9×10~9/L,分类;早幼粒2％,中幼粒20％,晚幼粒14％,可见少量中晚幼红细胞。住院
Patient, female, 52 years old. Due to fatigue 1 week hospitalization, during the discovery of sternal pressure disease, liver and spleen was significantly enlarged. 115g / L of hemoglobin, 275 × 10 ~ 9 / L of leukocytes, 56% of medium and late granulocytes, and 350 × 10 ~ 9 / L of platelets. Myeloid hyperplasia is extremely active, 92% of the granulocyte, 6% of the original early grain, eosinophilic, basophil and megakaryocyte more common diagnosis of chronic myelogenous leukemia. ph ’chromosome is positive. After the diagnosis by Maryland treatment, the symptoms improved, liver and spleen can not palpable when discharged. 1 year later due to fever half months, with fatigue, body pain again hospitalized. Physical examination; body temperature 39 ℃, obvious anemia appearance, the skin scattered in the bleeding point, sternal tenderness, liver ribs 2cm, spleen and umbilical cord. Hemoglobin 65g / L, white blood cells 20.9 × 10 ~ 9 / L, classification; promyelocytic 2%, 20% of juvenile, late promyelocytic 14%, showing a small amount of young and middle-aged red blood cells. Hospitalized